Journal List > J Korean Rheum Assoc > v.17(2) > 1003720

Kim, Kim, Jang, and Suh: Posterior Reversible Encephalopathy Syndrome in a Patient with Lupus Nephritis

Abstract

Posterior reversible encephalopathy syndrome (PRES) has been described in various clinical settings, including severe hypertension, eclampsia, lupus and immunosuppressive therapy. We report a 27 year-old female systemic lupus erythematosus patient who developed severe headache, seizure and hemiparesis during her lupus nephritis flare. Magnetic resonance image (MRI) showed multi-focal high signal intensity lesions in the parieto-occipital cortex bilaterally and in the subcortical white matter. Her condition improved with immunosuppressive treatments, antihypertensives and hemodialysis. The extent of her lesions decreased on follow-up MRI 2 months later. This case suggests that PRES can be treated with immunosuppressive drugs that do not increase blood pressure.

REFERENCES

1). Hinchey J., Chaves C., Appignani B., Breen J., Pao L., Wang A, et al. A reversible posterior leukoencephalopathy syndrome. N Engl J Med. 1996. 334:494–500.
crossref
2). Park M., Park Y., Moon J., Kim H., Lee S., Heo K, et al. Reversible posterior leukoencephalopathy syndrome in a patient with systemic lupus erythematosus. J Korean Rheum Assoc. 2002. 9:335–40.
3). Shin J., Son J., Kim D., Park J., Kim G., Song E, et al. Reversible posterior leukoencephalopathy syndrome in a patient with systemic lupus erythematosus treated with cyclosporine. J Korean Rheum Assoc. 2007. 14:291–6.
crossref
4). Shin KC., Choi HJ., Bae YD., Lee JC., Lee EB., Song YW. Reversible posterior leukoencephalopathy syndrome in systemic lupus erythematosus with thrombocytopenia treated with cyclosporine. J Clin Rheumatol. 2005. 11:164–6.
crossref
5). Ishikura K., Ikeda M., Hamasaki Y., Hataya H., Nishimura G., Hiramoto R, et al. Nephrotic state as a risk factor for developing posterior reversible encephalopathy syndrome in paediatric patients with nephrotic syndrome. Nephrol Dial Transplant. 2008. 23:2531–6.
crossref
6). Ito Y., Niwa H., Iida T., Nagamatsu M., Yasuda T., Yanagi T, et al. Post-transfusion reversible posterior leukoencephalopathy syndrome with cerebral vasoconstriction. Neurology. 1997. 49:1174–5.
crossref
7). Ito Y., Arahata Y., Goto Y., Hirayama M., Nagamutsu M., Yasuda T, et al. Cisplatin neurotoxicity presenting as reversible posterior leukoencephalopathy syndrome. AJNR Am J Neuroradiol. 1998. 19:415–7.
8). Baizabal-Carvallo JF., Barragan-Campos HM., Padilla-Aranda HJ., Alonso-Juarez M., Estanol B., Cantu-Brito C, et al. Posterior reversible encephalopathy syndrome as a complication of acute lupus activity. Clin Neurol Neurosurg. 2009. 111:359–63.
crossref
9). Prasad N., Gulati S., Gupta RK., Kumar R., Sharma K., Sharma RK. Is reversible posterior leukoencephalopathy with severe hypertension completely reversible in all patients? Pediatr Nephrol. 2003. 18:1161–6.
crossref
10). Mukherjee P., McKinstry RC. Reversible posterior leukoencephalopathy syndrome: evaluation with diffusiontensor MR imaging. Radiology. 2001. 219:756–65.
crossref
11). Vaughan CJ., Delanty N. Hypertensive emergencies. Lancet. 2000. 356:411–7.
crossref
12). Leroux G., Sellam J., Costedoat-Chalumeau N., Le Thi Huong D., Combes A., Tieulie N, et al. Posterior reversible encephalopathy syndrome during systemic lupus erythematosus: four new cases and review of the literature. Lupus. 2008. 17:139–47.
crossref
13). Ishimori ML., Pressman BD., Wallace DJ., Weisman MH. Posterior reversible encephalopathy syndrome: another manifestation of CNS SLE? Lupus. 2007. 16:436–43.
crossref
14). Lamy C., Oppenheim C., Meder JF., Mas JL. Neuroimaging in posterior reversible encephalopathy syndrome. J Neuroimaging. 2004. 14:89–96.
crossref
15). Kurahashi H., Okumura A., Koide T., Ando Y., Hirata H., Magota M, et al. Posterior reversible encephalopathy syndrome in a child with bronchial asthma. Brain Dev. 2006. 28:544–6.
crossref
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